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South Carolina rates for HCPCS 80177

Levetiracetam

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $97.72 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $10.96 / $35.48
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $9.12 / $9.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $35.48 / $81.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $15.85 / $21.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $33.88 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.89 / $8.32 / $19.05
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.00 / $12.30 / $19.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $13.18 / $15.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $9.12 / $22.39